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Understanding Keratoconus

Keratoconus is a progressive eye condition in which the cornea, the clear, dome-shaped front layer of your eye, thins and gradually bulges outward, forming a cone-like shape. This irregular curvature causes distorted vision, sensitivity to light, and can make standard eyeglasses insufficient for correcting vision.

Keratoconus often develops in adolescence or early adulthood, and its progression varies from patient to patient. Some people experience slow changes over many years, while others may notice rapid deterioration of vision if left untreated.

Keratoconus: Overview

What is Corneal Cross-Linking?

Causes and Risk Factors

While the exact cause of keratoconus is unknown, several factors can contribute:

Genetics

 A family history increases the likelihood of developing keratoconus. Regular screenings are recommended for relatives of affected individuals.

Chronic eye rubbing

Frequent rubbing, often caused by allergies, can accelerate corneal thinning.

Underlying conditions

Eczema, asthma, connective tissue disorders, and Down syndrome may increase risk.

Environmental factors

UV exposure, oxidative stress, and chronic irritation can play a role.

Biomechanical weakening

Some corneas are naturally more flexible or structurally weak, making them prone to bulging.

It’s important to note that keratoconus is not caused by poor vision habits or personal behavior; it is a biologically driven condition requiring monitoring and appropriate treatment.

Symptoms to Watch For

Common signs of keratoconus include:

  • Blurred or distorted vision
  • Difficulty seeing at night
  • Increased sensitivity to light and glare
  • Frequent prescription changes
  • Double or ghosted vision in one eye
  • Halos or irregular visual patterns
  • Sudden decrease in vision quality

Early symptoms can resemble mild astigmatism, which is why specialized testing is essential for accurate diagnosis.

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How Keratoconus Is Diagnosed

Our corneal specialists use advanced imaging and testing to evaluate the cornea’s shape, thickness, and structural integrity:

  • Corneal Topography: Maps the surface curvature to detect early steepening or asymmetry.
  • Corneal Tomography: Provides a 3D view of both front and back corneal surfaces.
  • Pachymetry: Measures corneal thickness to identify thinning.
  • Wavefront Analysis: Detects irregularities in how light passes through the cornea, highlighting distortions.

These tools allow us to assess keratoconus severity, monitor progression, and select the most effective treatments.

Stages of Keratoconus

Keratoconus progresses differently in each patient, but it’s often categorized as:

Mild

Slight corneal irregularity; vision may be correctable with glasses or soft lenses.

Moderate

Greater distortion; rigid gas-permeable or specialty lenses may be required.

Advanced

Significant thinning and steepening with potential scarring; surgical options may be necessary.

Acute hydrops

A rare complication where fluid enters a sudden break in corneal layers, causing rapid swelling and vision loss. Immediate medical attention is required.

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Professional & friendly all the way from 
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Had a visit with Dr. Morrow today and he was very thorough and helpful. I’d recommend this establishment to anyone.

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Very efficient. Wait time limited and they 
got me in quickly. Went above and beyond to make sure I was attended to.

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Very good experience. The best part was meeting the team everyone was so friendly. And I like the Dr I had. He was very thorough.

Delores B.

I am thrilled with the level of service that 
I have received. All staff members have been excellent to work with.

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Treatment Options

Modern keratoconus management focuses on halting progression and preserving vision while improving clarity.

Corneal Cross-Linking (CXL)

CXL is the only treatment proven to slow or stop keratoconus progression. This minimally invasive, FDA-approved outpatient procedure strengthens corneal tissue by creating new bonds in the collagen fibers.

How It Works:

  • The eye is numbed with drops, and the thin surface layer (epithelium) is gently removed.
  • Riboflavin (vitamin B2) drops, such as Photrexa®, are applied to the cornea for about 30 minutes.
  • The cornea is exposed to UVA light for 30 minutes while additional drops are applied.
  • A protective bandage contact lens is placed during initial healing.

Recovery and Aftercare:

  • Avoid rubbing your eyes for at least five days.
  • Mild discomfort or a foreign-body sensation is common; sunglasses help with light sensitivity.
  • Contact lenses should be discontinued one week before and for about one month after the procedure.
  • Total office time, including preparation and recovery, is approximately two to three hours.

Benefits of CXL:

  • Halts or slows keratoconus progression
  • Reduces the risk of needing a corneal transplant
  • Stabilizes corneal shape and long-term vision
  • Minimally invasive with no visible changes to eye appearance

Corneal Transplant

In rare, advanced cases with severe thinning, scarring, or distortion, a corneal transplant may be needed. Early detection and treatments like CXL have dramatically reduced the need for surgery.

What is Corneal Cross-Linking?

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A Positive Outlook for Your Results

With early diagnosis and treatment, most patients experience:

  • Long-term stabilization of vision
  • Reduced risk of severe progression
  • Improved visual quality
  • Delayed or eliminated need for corneal transplant

Why Choose Eye Surgeons of Indiana for Keratoconus Care

Keratoconus requires specialized treatment that evolves over time. At Eye Surgeons of Indiana, we take full ownership of each patient’s condition, from early diagnosis through long-term management. We use advanced corneal imaging to detect subtle changes, guide treatment decisions, and preserve your vision.

Prioritizing what is safest and most effective for your eyes is what we do. With expert oversight, innovative technology, and a commitment to doing what’s right, Indianapolis patients trust us to protect their vision for the future. You can too.

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